792 Brawley School Rd.
704.664.6264
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Employment
Join the Brawley Market & Carwash Family
Employment Application
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Position applied for
Date you can start
First Name
Middle Name
Last Name
Present Address
Address Line 1
Address Line 2
City
State
Zip Code
Permanent Address
Address Line 1
Address Line 2
City
State
Zip Code
Home Telephone
Work Telephone
Email
Are you 18 years or older?
Yes
No
Are there any hours of the week you cannot work?
Yes
No
Please provide details of the hours you cannot work
Type of employment wanted?
Full time
Part time
Are you employed now?
Yes
No
May we contact your present employer?
Yes
No
Were you referred by a current or former employee and if so who?
Education
Type of School
Name & address of school
Number of years attended
Did you graduate
Subject Major
Elementory School
High School
College
Specialised Training
Yes
No
Are you lawfully entitled to work in the United States?
Yes
No
Have you ever been convicted of a crime except a minor traffic violation?
Yes
No
Please state citation, date and place where offense occurred.
Please provide any additional information such as special skills, training, management experience, equipment operation, or qualifications you feel will be helpful to us in considering your application.
Professional References
Name
Address and Telephone
Relationshop
Years acquainted
Current and most recent employers
Date
Name, address, phone of employer
Position Held
Reason for leaving
May we contact the employers listed above
Yes
No
Which employers should we not contact
Please read the following statement carefully before signing to indicate your understanding:
I understand that, prior to being offered employment, I may be requested to take an employment examination. In the event that I have a disability that will affect my ability to take the test. I will so inform the Company prior to the administration of the test so that a reasonable accommodation can be made. The Company reserves the right to require medical documentation regarding the need for accommodation.
I certify that the facts contained in this application are true and complete to the best of my knowledge and understand that, if employed, falsified statements on this application may result in termination.
I understand and agree that, if hired, my employment is for no definite period and may, regardless of the date of payment of my wages and salary, be terminated with or without cause, at any time, with or without notice.
I authorize investigation of all statements contained in this application for any employment-related purpose. I release the listed references and all employers, except those specifically excepted,* to provide you with any and all applicable information they may have. I hereby release these references and former employers from all liability for any information they may give to you.
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